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J. Spindle, A. Z. Chuang, R. W. Yee; Long Term Cyclosporin A Improves the Confocal Tear Film Appearance. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6265.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of our study was to evaluate changes of the tear film in patients with dyfunctional tear syndromes using confocal microscopy after long term topical 0.05% cyclosporine A (Restasis) use.
Using our existing database of confocal tear film images, we found 9 patients (n=16 eyes) that had a baseline and follow-up images of greater than 1 year. The tear film images were graded independently by two masked graders on the 1-10 confocal tear film image scale previously presented (ARVO 2008) and averaged together for each eye at baseline and follow-up photograph between the treated and untreated dry eye groups. Representative tear fims are demonstrated with the the smoother tear films ranging from 3-5 and the more severe less homogeneous tear films ranging from 6-9. The delta change was then calculated in subgroups of those patients using cyclosporine A and those not using cyclosporine A during this time period. These data from these changes were then evaluated with a t-test.
The group of dry eye patients using cyclosporine A (n=9 eyes) for greater than one year had a statistically greater (p=0.03) average change of 2.0 units (SD=1.5, SEM=0.5) of improvement as compared to those not using cyclosporine A (n=4, 7 eyes) for greater than one year. This produced a 95% CI (0.176-2.824). Comparisons of images at baseline and 3 months did not demostrate significant changes using confocal microscopy.
Patients using long term cyclosporine A showed tear film improvement by confocal microscopy as compared to those not using topical cyclosporine a. Tear confocal microscopy may be more helpful in following the long term changes in the dysfunctional tear film.
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